Initial Business Response /* (1000, 5, 2014/03/14) */
Agent [redacted] sold Mr. [redacted] a Medicare Supplement policy in February that was to go into effect on March 1, 2014. The rates she used at the time were correct but she was not aware that Aetna had scheduled an increase for...
March 1st. She did not know anything about it until Mr. [redacted] notified her of the amount drafted from his account. She contacted Aetna and was told that the increase went into effect for all members and new applicants as of March 1st. She tried to get Aetna to honor the rate she quoted but was unsuccessful but she offered to put him with another carrier for the same plan at a rate more in line with the first quote. He declined that offer and continued to demand compensation for the difference. I contacted him about the situation and tried to come to an agreement with Mr. [redacted] but he then decided he was entitled to not only the difference in the premium, which is only $11.42 per month difference, but also for all that he had been through he wanted an additional amount of $750. I told him that we could not do that and would try to work with Aetna to correct the matter but he continued to threaten reporting us to every agency he could think of. I finally told him that I was not authorized to do anything more than to advise him that he had the right to cancel the new policy and go back to the original policy he had with Blue Cross and he would have his coverage without interuption. I feel that we have tried to work with Mr. [redacted] and I have tried to give him options but without success. He should direct his concerns to the carrier, Aetna, for a possible resolution.
Initial Consumer Rebuttal /* (3000, 7, 2014/03/18) */
(The consumer indicated he/she DID NOT accept the response from the business.)
I am a senior, and I was given inaccurate information from the agent. There was nothing Aetna the carrier would do to adjust the premium to what the agent represented. Aetna stated my only recourse was with the agent and the agency that sold me the policy. The fraud unit of the Department of Insurance has attempted to contact the agent, and to date the agent has not returned the communication, much like she has refused to communicate with me since she sold me the policy. Additionally she is operating in my state of Arizona without legal license in this state. When my case could not be resolved the agent attempted to sell me an alternative policy with a company rated by AM Best B+ and a Revdex.com rating of F with no accreditation. The agent wanted me to tell my existing carrier-Blue Cross to backdate my cancellation (I would not have cancelled had I known of the higher rate with Aetna), and was told by Blue Cross that is illegal. So neither the agent or her Director of Compliance understood this rule and wanted to dodge the problem with an illegal action. I did not request nor did I demand restitution of $750. That is just not an accurate statement the Director of Compliance has made, and I have the email records to substantiate that. This insurance agent did not know the billing situation with Aetna, when they would draw premium payments from my checking account, believing I could set the date late in the month, and this too proved to be misguided and lack of understanding of the company and its billing policy. Bottom line, this company, this agent and her Director of Compliance made multiple misrepresentations to me, and took advantage of a Senior, which has taken its toll on me. Companies and agents and Compliance directors need to be held accountable. The consuming public needs to be aware of so called professionals such as these folks and this company. There is no excuse for an insurance agent to sell a policy without knowing the particulars, without doing due diligence of the product being sold, misrepresent facts to cover up lack of knowledge, with a Director of Compliance who supports the action and does not understand the rules and laws.
Initial Business Response /* (1000, 11, 2014/09/18) */
Sent: Wednesday, September 17, XXXX X:XX PM
To: [redacted]
Subject: RE: Download Complaint Form.cf-8
Mr. [redacted]
In response to the complaint from [redacted], we do not promote or condone the behavior described in the...
complaint. We value and respect the wishes of our Senior clients and [redacted] do everything possible to address this issue with the agent involved. Our agents try to reach Seniors that have mailed in response cards for information on particular insurance products but are never to continue to call or visit if they have reached them and have been told that they are not interested. I have contacted the agent and his manager to address this issue and made it clear that neither of them should attempt to contact Mr. [redacted] or his mother any further. You may share my contact information with them should they have any further issues with any of our agents in their area. We [redacted] work with the agent to coach him and encourage proper marketing techniques for the senior market going forward. Thank you.
[redacted], CSA
Chief Compliance Officer
The Assurance Group, Inc.
Office: XXX-XXX-XXXX [redacted]
Fax: XXX-XXX-XXXX
Initial Business Response /* (1000, 5, 2014/03/14) */
Agent [redacted] sold Mr. [redacted] a Medicare Supplement policy in February that was to go into effect on March 1, 2014. The rates she used at the time were correct but she was not aware that Aetna had scheduled an increase for...
March 1st. She did not know anything about it until Mr. [redacted] notified her of the amount drafted from his account. She contacted Aetna and was told that the increase went into effect for all members and new applicants as of March 1st. She tried to get Aetna to honor the rate she quoted but was unsuccessful but she offered to put him with another carrier for the same plan at a rate more in line with the first quote. He declined that offer and continued to demand compensation for the difference. I contacted him about the situation and tried to come to an agreement with Mr. [redacted] but he then decided he was entitled to not only the difference in the premium, which is only $11.42 per month difference, but also for all that he had been through he wanted an additional amount of $750. I told him that we could not do that and would try to work with Aetna to correct the matter but he continued to threaten reporting us to every agency he could think of. I finally told him that I was not authorized to do anything more than to advise him that he had the right to cancel the new policy and go back to the original policy he had with Blue Cross and he would have his coverage without interuption. I feel that we have tried to work with Mr. [redacted] and I have tried to give him options but without success. He should direct his concerns to the carrier, Aetna, for a possible resolution.
Initial Consumer Rebuttal /* (3000, 7, 2014/03/18) */
(The consumer indicated he/she DID NOT accept the response from the business.)
I am a senior, and I was given inaccurate information from the agent. There was nothing Aetna the carrier would do to adjust the premium to what the agent represented. Aetna stated my only recourse was with the agent and the agency that sold me the policy. The fraud unit of the Department of Insurance has attempted to contact the agent, and to date the agent has not returned the communication, much like she has refused to communicate with me since she sold me the policy. Additionally she is operating in my state of Arizona without legal license in this state. When my case could not be resolved the agent attempted to sell me an alternative policy with a company rated by AM Best B+ and a Revdex.com rating of F with no accreditation. The agent wanted me to tell my existing carrier-Blue Cross to backdate my cancellation (I would not have cancelled had I known of the higher rate with Aetna), and was told by Blue Cross that is illegal. So neither the agent or her Director of Compliance understood this rule and wanted to dodge the problem with an illegal action. I did not request nor did I demand restitution of $750. That is just not an accurate statement the Director of Compliance has made, and I have the email records to substantiate that. This insurance agent did not know the billing situation with Aetna, when they would draw premium payments from my checking account, believing I could set the date late in the month, and this too proved to be misguided and lack of understanding of the company and its billing policy. Bottom line, this company, this agent and her Director of Compliance made multiple misrepresentations to me, and took advantage of a Senior, which has taken its toll on me. Companies and agents and Compliance directors need to be held accountable. The consuming public needs to be aware of so called professionals such as these folks and this company. There is no excuse for an insurance agent to sell a policy without knowing the particulars, without doing due diligence of the product being sold, misrepresent facts to cover up lack of knowledge, with a Director of Compliance who supports the action and does not understand the rules and laws.
Initial Business Response /* (1000, 11, 2014/09/18) */
Sent: Wednesday, September 17, XXXX X:XX PM
To: [redacted]
Subject: RE: Download Complaint Form.cf-8
Mr. [redacted]
In response to the complaint from [redacted], we do not promote or condone the behavior described in the...
complaint. We value and respect the wishes of our Senior clients and [redacted] do everything possible to address this issue with the agent involved. Our agents try to reach Seniors that have mailed in response cards for information on particular insurance products but are never to continue to call or visit if they have reached them and have been told that they are not interested. I have contacted the agent and his manager to address this issue and made it clear that neither of them should attempt to contact Mr. [redacted] or his mother any further. You may share my contact information with them should they have any further issues with any of our agents in their area. We [redacted] work with the agent to coach him and encourage proper marketing techniques for the senior market going forward. Thank you.
[redacted], CSA
Chief Compliance Officer
The Assurance Group, Inc.
Office: XXX-XXX-XXXX [redacted]
Fax: XXX-XXX-XXXX